AB1112 SARS-COV-2 INFECTION AND IT VACCINATION IN AUTOINMUNE DISEASE-ASSOCIATED INTERSTICIAL LUNG DISEASE
Authors: A. Garcia Studer, M. Rojas-Giménez, M. Velloso Feijoo, C. M. Romero-Barco, F. Godoy-Navarrete, N. Mena-Vázquez
Journal: Annals of the Rheumatic Diseases (2022)

Background Intersticial lung disease (ILD) is a common condition in patients with systemic autoinmune diseases (SAI) that is characterized by increased morbility and mortality. Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has posed huge challenges worldwide and previous studies suggest that ILD patients experience a more severe clinical course. Objectives To analyze COVID-19 infection effects in patients with ILD associated systemic autoinmune disease (ILD-SAI) and to describe their vaccination status. Methods Design We performed a multicenter, retrospective, observational study from 6 teaching hospitals in Andalusia, Spain. Study protocol We included ILD-SAI patients: rheumatoid arthritis (RA), systemic sclerosis (SS) and inflammatory myopathies (IM), assisted in reumatology consultations in 2021. Variables COVID-19 infection was the main variable that we collected and it was confirmed by a positive result on a PCR test. Secondary variables: (1) COVID-19 severity defined as hospitalization or death; (2) vaccination status; (3) temporary relationship between infection and vaccination. Other variables included: clinical, epidemiological characteristics, treatments received, type of ILD (UIP/NSIP), pulmonary function testing and high-resolution computed tomography. Statistic analysis Two multivariable logistic regression analysis to indentify the “COVID-19” and “severe COVID-19” associated factors. Results We included 176 ILD-SAI, of whom: 105 (59.7%) had RA, 49 (27.8%) had SS and 22 (12.54%) had IM. The main baseline characteristics for the oversall simple and te 3 subgroups are shown in Table 1. Table 1. Clinical and epidemiological characteristics of 171 ILD-SAI patients. Variable Rheumatoid artritisn=105 Systemic sclerosisn=49 Inflammatory myopathies n=22 p-value Sex, women, n (%) 58 (55.2) 42 (85.7) 17 (77.3) &lt;0.001 Age in years, mean (SD) 67.9 (9.6) 60.9 (12.5) 55.7 (18.9) &lt;0.001 SAI evolution time, month, median (IQR) 46.2 (25.4-79.0) 67.1 (52.2-88.2) 39.1 (25.1-72.5) 0.010 Radiological patterns &lt;0.001 UIP, n (%) 66 (62.9) 8 (16.3) 1 (4.5) NSIP n (%) 32 (30.5) 39 (79.6) 20 (90.9) Last PFT FVC, mean (SD) 70.7 (19.9) 71.3 (21.4) 73.1 (16.6) 0.471 FEV1, mean (SD) 71.2 (19.3) 72.2 (17.3) 74.4 (17.9) 0.345 SB-DLCO, mean (DS) 54.3 (16.5) 52.4 (15.9) 60.8 (15.2) 0.140 Treatment sDMARD, n (%) 88 (86.3) 10 (20.4) 11 (50.0) &lt;0.001 Biologic DMARD, n (%) 47 (46.1) 14 (28.6) 6 (27.3) 0.590 Immunosuppressants, n (%) 37 (36.3) 33 (67.3) 17 (77.3) &lt;0.001 Corticosteroid, n (%) 72 (71.3) 24 (49.0) 18 (81.8) 0.007 COVID-19 COVID-19 infection, n (%) 14 (13.3) 4 (8.2) 4 (18.2) 0.460 Severe COVID-19 infection, n (%) 7 (50.0) 0 (0.0) 0 (0.0) 0.085 Complete COVID-19 vaccination, n (%) 94 (89.5) 47 (95.9) 22 (100.0) 0.135 We recorded 22/179 (12.5%) SARS-CoV-2 infections, 7/22 (31.8%) of them were severe and 3/7 (42.85%) died. As to the vaccination, 163/176 (92.6%) patients received the complete dosis. Among those correctly vaccinated 18/163 (11%) had the SARS-CoV-2 infection, 4/18 (22.2%) after the vaccinated date and 14/18 (77.7%) when they still dint´t have the complete vaccination. From the 13 not vaccinated patients, 4/13 (30.7%) had COVID-19. As to frequency, COVID-19 severity and vaccination, there were no difference between subgroups of CTD-ILD patients. The risk factors associated with the COVID-19 infection were the last FVC (OR [CI 95%], 0.971 [0.944-0.998]; p=0.048), the vaccination (OR [CI 95%], 0.185 [0.049-0.691]; p=0.012) and the Rituximab treatment(OR [CI 95%], 3.172 [1.028-6.785]; p=0.045). Moreover, the only variable associated independently with the severe COVID-19 was the protective effect of vaccination (OR [CI 95%], 0.020 [0.003-0.119]; p&lt;0.001). Conclusion A total of 12.5% ILD-SAI patients were COVID-19 infected, most of them without the complete vaccine. Rituximab and a deterioration of FVC were risk factors for the COVID-19 wehreas the vaccination was a protective factor for the mild and severe infection. Disclosure of Interests None declared